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Sclera Anatomy

The sclera forms the posterior five-sixths of the outer fibrous tunic of the eyeball. It is thickest posteriorly at 1mm and thins anteriorly and at the insertion points of the extraocular muscles. The sclera has three layers - an outer episcleral layer, a dense middle sclera proper layer, and an inner lamina fusca layer. It contains apertures for vessels and nerves and has an episcleral blood supply and nerve fibers from the posterior ciliary nerves. The sclera functions to protect the intraocular structures, maintain the shape of the eyeball, and provide attachment points for the extraocular muscles.

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Miriam Mwangi
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190 views21 pages

Sclera Anatomy

The sclera forms the posterior five-sixths of the outer fibrous tunic of the eyeball. It is thickest posteriorly at 1mm and thins anteriorly and at the insertion points of the extraocular muscles. The sclera has three layers - an outer episcleral layer, a dense middle sclera proper layer, and an inner lamina fusca layer. It contains apertures for vessels and nerves and has an episcleral blood supply and nerve fibers from the posterior ciliary nerves. The sclera functions to protect the intraocular structures, maintain the shape of the eyeball, and provide attachment points for the extraocular muscles.

Uploaded by

Miriam Mwangi
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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SCLERA

ANATOMY

PRESENTED BY:
MARGARET MWANGI
HND/OPHT/21001/001
NAIROBI CAMPUS
17/12/2020
OBJECTIVES

• At the end of this presentation we should be able to:-


• Describe the appearance, location and size of the sclera.
• Describe the embryology of the sclera.
• Describe histology, blood and nerve supply of sclera.
• State the functions of the sclera.
• Outline the clinical application of sclera.
INTRODUCTION

➢ Sclera forms posterior 5/6 th opaque external


fibrous tunic of the eyeball.
➢ Outer surface is covered by Tenon's capsule.
➢ Anteriorly begins at the limbus.
➢ Posteriorly terminates at the optic nerve canal.
➢ Anterior surface is covered by bulbar conjunctiva.
➢ Inner surface lies in contact with choroid with
a potential suprachoroidal space in between.
THICKNESS OF SCLERA

➢ Thickness varies with individuals and age.


➢ Thinner in children than adults.
➢ Thicker in males than females.
➢ Thickest posteriorly (1mm) and thins anteriorly.
➢ Thinnest at the insertion of extraocular muscles(0.3mm).
➢ Measures 0.83mm at the limbus.
EMBRYOLOGY OF THE SCLERA

• Develops from neural crest mesenchyme.


• Starts to develop at the 5 th week gestation.
• Begins to develop at the limbus
and continues posteriorly up to the optic nerve.
• 3rd month developing choroid surrounds it.
• 4th month lamina cribrosa begins to form.
• 5th month sclera is well differentiated.
HISTOLOGY OF THE SCLERA
MICROSCOPIC STRUCTURE

EPISCLERA

• It is a thin, dense vascularized layer of connective tissue.


• Forms outermost layer of the sclera.
• Covers sclera proper.
• Consist of bundles of collagen fibers
arranged circumferentially.
• Also contains fibroblasts, macrophages and lymphocytes.
• Thickest anteriorly at insertion of rectus muscle
and thins towards the posterior part.
SCLERA PROPER

• Its the middle layer of the sclera.


• Its avascular and consist of dense bundles
of collagen fibers criss- crossing each other.
• That arrangement makes the sclera opaque.
• Also contains proteoglycans and glycoproteins.
• Few fibroblasts are also present.
• Deficiency in water binding substance accounts
for sclera dull white colour.
LAMINA FUSICA

• It is the innermost layer of the sclera.


• Blends with the suprachoroidal and supraciliary
lamina of uveal tract.
• Presence of pigmented cells (melanocytes)
gives it the brownish colour.
SPECIAL REGIONS OF THE SCLERA

Scleral sulcus
• It is a furrow on the inner surface
of the limbus.
• Provides attachment for ciliary body.
Scleral spur
• It is a protrusion of the inner surface
of the sclera near the limbus.
• Prevents ciliary muscles from causing schlemms
canal to collapse.
Lamina cribrosa
• Thin sieve like sclera where fibers
of optic nerves pass.
Canal of schlemm
• Circular canal found at the posterior
part of the limbus. Drains aqueous humour
SCLERAL APERTURES

Sclera pierced by 3 types of apertures:-


• Posterior aperture-situated around optic nerve.
- Transmit long and short ciliary vessels.
• Middle aperture-situated 4mm posterior to
the equator, four in number.
- Transmit four vortex veins.

• Anterior aperture-situated 4mm posterior to


the equator near insertion of recti muscles.
- Transmit anterior ciliary vessels.
BLOOD SUPPLY & VENOUS DRAINAGE

• Episclera- anterior and posterior ciliary arteries.


Sclera proper - relatively avascular structure.
• Venous drainage by episcleral collecting veins
that drain into anterior ciliary veins.
NERVE SUPPLY

-Sclera is rich in nerve supply.


-Anterior sclera-long posterior ciliary nerves.
-Posterior sclera-short posterior ciliary nerves.
FUNCTIONS OF THE SCLERA

• Protects intraocular components from trauma, light


and mechanical displacement.
• Maintain the shape of the globe
along with the intraocular pressure of the eye.
• Provide attachment site for extraocular muscles.
CLINICAL SIGNIFICANCE

• Scleral icterus-yellowing of the sclera


associated with liver disease.
• Blue sclera-diseases of the connective tissue
e.g. osteogenesis imperfecta and Marfans syndrome.
Iron deficiency-blue tint on sclera.
• Episcleritis-inflammation of episclera,sclera appears red.
• Scleritis- inflammation of sclera.
REFERENCES

• http:/www.slideshare.net/sushmarsudhakar2/
anatomy-of-sclera-88620363.
• www.eophtha.com
• www.kenhub.com.
• Eyewiki.AAO.December 2015-scleritis
SUMMARY

Sclera anatomy
➢ Forms posterior 5/6th of external fibrous
tunic of eyeball.
➢ Continues with dura matter and cornea.
➢ Whole surface covered by Tenon's capsule.
➢ Covered by bulbar conjunctiva anteriorly.
➢ Inner surface lies in contact with choroid with
a potential suprachoroidal space in between.
SCLERA THICKNESS

➢ Varies with individuals and age.


➢ Thinner in children than adults.
➢ Thicker in males than females.
➢ Thickest posteriorly, thins anteriorly and at insertion
of extraocular muscles.
➢ Posteriorly 1mm,0.83mm at limbus,0.3mm
at insertion of extraocular muscles.
Layers of the sclera
➢ Episclera
➢ Sclera proper
➢ Lamina tunica
Scleral apertures
➢ Posterior aperture
➢ Middle aperture
➢ Anterior aperture
Blood and nerve supply/venous drainage

➢ Blood supply -Episclera by anterior and posterior


ciliary arteries. Sclera proper is relatively avascular.
➢ Venous drainage- Episcleral collecting veins
➢ Nerve supply-Anterior sclera by long posterior ciliary nerves.
-Posterior sclera by short posterior ciliary nerves.
➢ Functions-Protection of intraocular contents.
-Maintain shape of eyeball together with intraocular pressure.
-Site for extraocular muscles attachment.
THANK YOU

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